Blog Reader Question on Bipolar Disorder and Anxiety

Hi Julie,

I am having a really rough time with anxiety and i haven’t been able to track down what the issue is. I’ve also been cycling very rapidly from morning to night. Wish i knew what the problem is. Gail

Hi Gail,

I’ve had anxiety for many years- it’s a normal part of bipolar and it can be reduced. It comes from many areas:

1.  Work- sometimes the requirements of work are stressful for people with bipolar disorder.  I remember working as a teacher- as long as I was with my students I was fine- but when the classes ended, I would go into the teacher’s lounge and lie on the couch. I am not like that at all anymore now that I do the stuff in my books- I can work through the anxiety, but it is still often there

2. Relationships- I don’t date because the situation adds too much pressure to my brain and the anxiety and OCD get bad.  I think we all have our weak spots for anxiety. Also, any difficult relationship can lead to anxiety. Calm relationships are essential. Yes, it’s hard to do this if the troublesome person is a partner, family member or coworker, but it has to be done. If you look at the relationship tab to the right or read Loving Someone with Bipolar Disorder ( for partners, it helps) there are suggestions.

3. Travel- this causes stress for most with bipolar as there are often time changes, lots of people in airports, tons of things to do before you go and family member squabbles- this doesn’t mean you won’t have fun- it means that the travel itself can be difficult.

4. Caffeine- people with anxiety should cut out caffeine completely and see if it helps. My coauthor Dr. John Preston says that if you do drink caffeine, you should keep it to less that 250 mg a day.

5.  Medications- many meds can make you nervous, shaky, jittery or just worried. Check with your doc if you think this is the case. Be very careful with herbs and supplements as well.

6.  Bipolar Disorder Itself- sometimes the anxiety is purely from the illness without a trigger. Mania can be really, really anxiety causing if it’s dysphoric mania. In fact, dysphoric mania means agitated mania.   90% of depression has mania.  So the better you treat bipolar, the less anxiety you can have. This is hard to deal with of course as you can’t simply stop doing something in order to get better.  Medications such as Ativan or Klonopin can really help here. I use Ativan in very small amounts- .5 mg for example. Yes, they can be addictive – but most people with bipolar disorder take them without getting addicted, so make sure your doctor doesn’t simply say no because of the addiction chance. He or she can give you just a few to start.  Some people with bipolar have the anxious type- this means the better they manage the bipolar, the less anxiety they have.  My book Take Charge of Bipolar Disorder has a good treatment plan for this.

I could go on for pages, but I will stop here- all of my books, especially The Health Cards Treatment System for Bipolar Disorder  talk about anxiety – you can read more about them on  www.BipolarHappens.com.

I also feel the Complete Idiot’s Guide to Anxiety by Joni Johnston is excellent.

Thanks for writing,

Julie

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